NPIMap

Organization Active NPI

Hermiston Medical Center P C

Doing business as Family Health Associates

  • Family Medicine Physician
  • Hermiston, OR
National Provider Identifier
1467403329
Registry record updated Jan 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD14374 Issued in OR
Legal business name
HERMISTON MEDICAL CENTER P C
Doing business as
Family Health Associates
Practice address
600 NW 11TH St
Suite E 15
Hermiston, OR 97838
Phone
(541) 567-6434
Fax
(541) 567-6019
NPI assigned
May 15, 2006
Last updated
Jan 9, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Derek Ted Earl, MDNPI 1538241799
Title
Medical Director
Phone
(541) 567-6434

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD08491 OR
Family Medicine Physician 207Q00000X MD11635 OR
Family Medicine Physician 207Q00000X DO23298 OR
Family Medicine Physician 207Q00000X MD14374 OR Primary

Addresses

Primary practice location

600 NW 11TH St
Suite E 15
Hermiston, OR 97838

Mailing address

600 NW 11TH Street
Suite E 15
Hermiston, OR 97838
Phone (541) 567-6434

Other practice location 1

1890 7th St
Umatilla, OR 97882-9826
Phone (541) 567-6434

Other practice location 2

251 NE Eldrige Drive
Boardman, OR 97818
Phone (541) 567-6434

Other practice location 3

10 NE 5th Ave
Milton Freewater, OR 97862-1702
Phone (541) 567-6434

Other identifiers 2

IdentifierTypeStateIssuer
083709MedicaidOR
194175200OtherW C

Other names 1

  • Family Health Associates Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250303002434 OR Part B Supplier - Clinic/Group Practice 9133028798 Receives reassigned benefits from 10 practitioners
Practice locations: Boardman, OR; Hermiston, OR; Milton Freewater, OR; Umatilla, OR

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Locations

10 NE 5th Ave
Milton Frwtr, OR 97862
Phone (541) 567-6434

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736380800000",
    "number": "1467403329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 NW 11TH STREET",
            "address_2": "SUITE E 15",
            "city": "HERMISTON",
            "state": "OR",
            "postal_code": "97838",
            "telephone_number": "541-567-6434",
            "fax_number": "541-567-6019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 NW 11TH ST",
            "address_2": "SUITE E 15",
            "city": "HERMISTON",
            "state": "OR",
            "postal_code": "97838",
            "telephone_number": "541-567-6434",
            "fax_number": "541-567-6019"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1890 7th St",
            "address_purpose": "LOCATION",
            "city": "Umatilla",
            "state": "OR",
            "postal_code": "978829826",
            "country_code": "US",
            "telephone_number": "541-567-6434",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "251 NE Eldrige Drive",
            "address_purpose": "LOCATION",
            "city": "Boardman",
            "state": "OR",
            "postal_code": "97818",
            "country_code": "US",
            "telephone_number": "541-567-6434",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10 NE 5th Ave",
            "address_purpose": "LOCATION",
            "city": "Milton Freewater",
            "state": "OR",
            "postal_code": "978621702",
            "country_code": "US",
            "telephone_number": "541-567-6434",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "HERMISTON MEDICAL CENTER P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-15",
        "last_updated": "2025-01-09",
        "certification_date": "2025-01-09",
        "status": "A",
        "authorized_official_last_name": "EARL",
        "authorized_official_first_name": "DEREK",
        "authorized_official_middle_name": "TED",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "541-567-6434",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD08491",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD11635",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "DO23298",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD14374",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "083709",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "W C",
            "identifier": "194175200",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Health Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hermiston, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.